tv Sanjay Gupta MD CNN July 17, 2011 4:30am-5:00am PDT
thanks for joining us. i'm dr. sanjay gupta. this fall will mark a full decade that the united states has been at war. it's left a mark in many ways, including the strong connection between the battlefield and medical care at home. i work at a level one trauma center at grady hospital. as a neurosurgeon i handle all sorts of things, gunshot wounds, car crashes and other injuries. some of the techniques that we use, for example, cutting out part of the skull to relieve pressure on the brain was developed in the military. in the last decade out of necessity. it is not a one-way connection.
cnn pentagon correspondent barbara starr spent time with a group of doctors, medics, nurses and medical teches who are all themselves now getting ready to deploy. for these men and women heading off to war, a big city hospital like the one where i work, can be a perfect training ground. >> reporter: dr. john renshaw stops to check on one of his patients. he suffered massive injuries at his job when he was caught in a conveyer belt. his cousin translates into their native haiti. renshaw is an oncologist. he treats cancer. why is he here? dr. john renshaw is major john renshaw, united states air force. he's deploying to the front lines of afghanistan to treat the war wound. but before he goes, he along
with other military medical personnel will complete a tour of duty here at the university of maryland shock trauma center in baltimore. sharpening their ability to deal with critical trauma patients. >> the wounds appear to be superficial. >> category "a" now. >> trauma. >> trooper one. 15 up, 10 minutes back, fall from tree. category "a," priority 1. >> every day, dozens of trauma patients are wheeled into these bays. some are accident victims. this young man came with multiple stab wounds. but right alongside the civilian trauma doctors, nurses and techs, military personnel. colonel david powers, a surgeon, runs the military training program here. >> the injuries i've treated here and that i see her at this hospital are the closest thing to the injuries i saw in iraq that i've experienced in the
continental united states. >> >> reporter: listen to what powers has encountered in recent weeks here. >> i've had a gentleman whose entire scalp was torn off in an industrial accident. i've had an individual who's now been involved in a motor vehicle accident who has intercranial injuries write have to re-create the cranial vault and frontal sinus exactly like i have to do with an ied blast. >> reporter: this doctor teaches other military colleagues his specialty, trauma surgery and surgical critical care. he notes many deploying military personnel from stateside bases don't raegly see critical trauma cases. >> what does an air force medical person, a doctor, a medical tech learn here before they go to the war zone? >> all of the basic skill set they're going to need in the early phases after injury and the ability to manage that patient airway, treating hemorrhage and bleeding, treating intercranial injury.
>> reporter: and it's skills that will come back home with them. he says the war has led to advances in controlling bleeding, monitoring fluids and caring for brain injuries. >> all these things are lessons that we're learning hard-fought lessons on the battlefields of afghanistan and iraq that can be translated to critical care. >> reporter: this doctor cert y certifies patients are healthy enough to fly. before getting to afghanistan he says, this will help him learn to prioritize multiple critical patients under battlefield conditions and sharpen his ability to make rapid decisions. >> i expect to see gunshot wounds. i expect to see traumatic brain injuries from explosive devices, burns as well. a lot of orthopedic injuries. and really, some horrific stuff.
and what i'm doing here is getting exposure to a lot of the things i'll be seeing over there. it's an emergence really in a high volume trauma center. >> reporter: you may not s lo be knowledge for all doctors. >> there's been a century long interplay between civilian and military care. in many ways trauma surgeons have learned from military conflict more so than any other component of care. >> reporter: as major renshaw's patient jacques continues to recover, the doctor says the training he receives here is vital. >> this gives me exposure to the trauma mindset, telling me what to look out for, pitfalls to avoid, procedures that i need to get my skills back up. >> joining us again is barbara starr. it's one of these things, i wonder, no matter how much you prepare it will be completely different still in some ways.
you've seen this firsthand, as i have, in afghanistan and iraq. were they nervous? were they well prepared? >> i think the doctors we spoke to were happy to have this 30-day tour of duty before they go to the war zone. it began to show them what they'll be facing over there. one of the doctors is an oncologist. he treats cancer patients. he said he's learning yet again how to put in chest tubes, control bleeding. restore breathing when someone may be so traumatically injured. it's not the kind of things doctors may have done since they were interns or residents. they're getting back into the basic skills and learning how to step it up, move fast, make decisions fast. >> i think people forget that. as an oncologist you're not taking care of traumatic injuries on a bailey basis. when you go there to afghanistan and iraq, the conditions are different in different places.
do they know what specific settings they'll be in ahead of time? >> some of them did, some of them don't. they're doing a variety of jobs. one of the other things that's going on at the shock trauma hospital we went to, they have regular conference calls with medical folks in the war zone every week to say, okay, what's going on, what are you seeing, how are you treating that? how do we have to adjust our training program back here. >> wow. >> everybody is trying to stay up with the latest. >> i think that's fascinating. those conference calls probably really help. >> they do. they tell us they do. i think what really has emerged from everything you and i have been talking about, is if you have to go to your local emergency room, your community hospital, your doctor, the chances are these days now you will encounter someone that has done a tour of duty in the war
zone. >> yes. >> there are thousands of medical personnel that have served, have now come back home, fanning out across this country. the war isn't so far away. it may be helping you back at home. >> that's right. it's a unique experience for those doctors and hopefully translates into better medical care. thanks, barbara. >> it's been great. we talk to a man who stirred up a lot of controversy essentially running life and death experiments for the army. we'll explain. we'll be right back. [ both ] oooooh... what's shakin'? [ female announcer ] as you get older, protein is an important part of staying active and strong. new ensure high protein... fifty percent of your daily value of protein. low fat and five grams of sugars. see? he's a good egg. [ major nutrition ] new ensure high protein. ensure! nutrition in charge!
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3,000 americans will die from food poisoning this year. check your steps at foodsafety.gov. the advances in military medicine over these past ten years at war have been nothing short of astonishing. but you might not realize is just how much these battlefield breakthroughs affect your -- just about every aspect of health back home. joining me to talk about this from houston, dr. john holcombe. thanks for being on the show again. >> sanjay, it's nice to hear from you again. >> we've been reporting on this forle some time, as you know, doctor. as a starting point, can you talk about some of the things that have changed over the last ten years, what we're starting to learn from the battlefield and apply back home? >> right. it's a great question. you know, i think you have to
divide this into different areas. i think of advances in the prehospital area, advances in the hospital, advances from a systems point of view, working across the entire battlefield and then obviously advances from a research point of view and how those intermingle with the civilian community. >> right. if you think about, for example, let's take prehospital as a starting point. the way that a patient is assessed in the field at the time of trauma, what -- are there some examples you can share, what we learned on the battlefield and they're not doing at home? >> right. i think at the beginning of the war we put in place with a lot of people all working together tourniquets on the battlefield, devices and hoemostatic devices. those three technologies, devices, have really been implemented in the civilian communities in the united states
and around the world. in some places obviously more than others but starting to spread like wildfire across the united states. >> what about in the hospital itself? when they come to see you as a trauma surgeon. what may be different. >> the general consensus is the way the patients are resuscitated. at the beginning of the war you would see people hanging clear bags ever fluid, then starting red cells and plasma and platelets in a serial fashion. what many places around the country do now, as soon as a patient comes in that needs resuscitation, you don't hang clear fluid. you hang red blood cells, plasma, et cetera. it appears to be -- >> you may not need as much if you use the red blood cells earlier.
let me ask you a broader question. is it easier continue knto inno battlefield than it is back home? >> that's a pretty complicated question, actually. innovation happens all the time and in multiple places. the rules for research and innovation are the same as they are back home with institutiona review boards. there are no differences. what is different on a battlefield, the number of severely injured patients is three to four times greater than what we see in a civilian community. the docs and nurses are living together, eating together and all you really do is work, eat, sleep and occasionally work out. there's no other distractions. it's a simple lifestyle, focused completely on patients. i think lifestyle and the larger number of injured patients coming in is what causes innovations to spring from war. >> if you have situations of war
where you have mass casualties, you have a, in some situations, may have fewer resources saerl of the setting in which these doctors are practicing and these nurses, are they forced to innovate in a different way? when you talk about advances being made on the battlefield, why if it's the same do they occur on the battlefield in this manner versus in civilian populations? >> it goes back to what we just talked about. all you do on the battlefield all day long every day is think about how to do things better. and there's no other -- it's a cauldron of innovation and absolute desire to take better care of the next patient. that really -- that happens in the civilian world but not to the same degree. it's just a different environment. where everybody is thinking constantly of how to do better the next time, the next day, the next hour, the next day. >> do you think that there's enough resources, money being spent on medical research in the
battlefield situations? >> i think it's absolutely -- medical research for trauma in general is underfunded. trauma's the leading cause of death in the united states and to civilians in ages 1 to 44, it's the leading cause of life years lost. it's been well documented for the last 40 to 50 years by institute of medicine reports, et cetera. the societal impact is unbelievable and the amount of funding coming from the federal agencies is insignificant compared to impact on society. if we studied resuscitation or in the civilian world with when the war started we'd know the best way to resuscitate patients. those are the conversations we had with congressmen and senators that came to visit us in san antonio. you have to study these things in the civilian world. when war starts you have the level one data and know how best
to take care of the casualties. we're starting to do the level one, high quality studies now, ten years into a war. >> i always learn something from you. thank you for visiting with us. >> no problem. the man flying this plane wasser itified of small confined places. seems like this would be the last place he'd want to be. hear how he beat it, that's next. this past year alone there was a 93% increase in cyber attacks. in financial transactions... on devices... in social interactions... and applications in the cloud. some companies are worried. some, not so much. thanks to a network that secures it all and knows what to keep in, and what to keep out. outsmart the threats. see how at cisco.com cisco. [ jim ] i need to push out a software upgrade.
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most people would want to scream. but air force lieutenant colonel rob waldman has faced his fears. and he did it the hard way. >> screaming engines, mind-numbing speeds of over 1900 miles an hour. this was lieutenant colonel waldman's daily ride. he had what many would consider one of the coolest jobs in the world. >> it's an amazing jet. f-16. >> but an innocent diving trip would change everything. >> three years into my flying year i almost died in a scuba accident in the caribbean. >> 30 feet underwater, rob's scuba mask broke. physically he was fine, but mentally he was shaken to the core. he developed severe claustrophobia. >> so if you can imagine barely being able to move with this helmet and mask on, gloves, your head two inches from the canopy. you're like in a little coffin, enough for a guy with claustrophobia to really feel
panicky. i had to live with this fear of having a panic attack. >> but a panic attack while going mock 2 two would be devastating. >> when you're strapped into a jet, you can't say pause, on combat missions where there was a job to do and my wing needed me, there was no aboard option for me. >> ultimately, he said it was family and faith that helped him overcome his fears. >> i would simulate the environment i would be in before the flight and say okay, i may have a panic attack here. how am i going to deal with it? i would look down at my collect list and i saw a picture of my niece and nephew and said i've got to get home for them. >> now waldo says he's kicked claustrophobia for good. >> i think about the challenge and personal growth that i had because i took a risk to fly that plane. i didn't want to look back on my life and say if i only had courage to take action, i could have flown the coolest jet in the world which in my opinion is
the lockheed martin f-16. >> i've flown in one of these jets before and it is pretty frightening. even if you don't have clause tau phobia. thanks a lot for sharing your story with us. up next, we're going to introduce you to a doctor who takes care of kids looking to set a better example for them. i'm phil mickelson, pro golfer. if you have painful, swollen joints, i've been in your shoes. one day i'm on p of the world... the next i'm saying... i have this thing called psoriatic arthritis. i had some intense pain. it progressively got worse. my rheumatologist told me about enbrel. i'm surprised how quickly my symptoms have been managed.
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checking in now and another member of our six-pack. we first met dr. scott zon when he submitted his video to be part of our triathlon challenge after his own doctor put him on medications for high cholesterol and high blood pressure. we did tell you after just a few months of training with us, he was able to stop taking one of those medications. another good update from scott. he weighed 270 pounds when this
began and has dropped now to less than 200. for the first time in a long time. i'm not sure how long it's been. i'm going to ask him. dr. scott joins us from green bay, wisconsin. hey, doc, how you doing? >> doing good. >> so how long has it been since you weighed below 200? >> i was trying to figure that out. it's been at least probably since college. so i'm 46 so at least 20 years. >> wow. that's got to feel pretty good, i'm sure. you're also able to run, i guess you say nine-minute miles, which is -- it's quite remarkable. you weren't running a lot before. how does it just feel to be coming that athletic? >> i really wasn't running much at all. i probably couldn't run a mile. to be running nine i minute miles for me is incredible. i never thought i would get to that point. i have lots of energy, the things i'm able to accomplish now, i never thought that i would get to this point.
>> what has been the hardest part? have there been walls that people talk about the proverbial wall that you hit in the midst of your training? did you hit that, and how did you get through it, if you did? >> i've hit some walls just really sore and achy. didn't really think that i could, you know, even get up the next day to work out and just kind of worked my way through it. just exercised more, changed my routine a little bit, and that helped me to get through some of those walls. >> you're a doctor. you take care of kids primarily. has there been a reaction from your patients to seeing you, the physical difference in you and just your attitude? the teenagers have the inned it, but probably more the parents have noticed. some i haven't seen for six months or a year and they're shocked when i walk in the door.
that's kind of a cool thing to see, you know, the reactions that i get when the i walk in and they're surprised at how different i look. >> yeah, i bet. i mean, i'm just even looking at you, it's quite a transformation. the question i get all the time, i want to ask you as well, you're a doctor, you have a wife, have you four children. you're a busy guy, and yet you have made this time to incorporate this triathlon training into your life. no small commitment. how do you do it? what's the advice you would give to other people? >> well, you got to put it as a priority in your life. equal to everything else. work and family and friends. i get up earlier in the morning and get in a lot of workouts in before i have to come to the office. the other thing i do is i'm working out a lot with friends and family. so i'm -- i'm working out and spending time with those people at the same time. >> you know, it's interesting because i do a lot of the same things. i try and take my kids who are very young but sometimes they come along on the workouts with me, pushing them along in the jogging stroller or going to the park while i swim. i'm proud of you, scott. you look great.